The primary objective of this study is to evaluate the effect of Samelisant on excessive daytime sleepiness (EDS) after 12 weeks of treatment. In addition, the study aims to assess its effectiveness in influencing the weekly frequency of cataplexy episodes (sudden bouts of muscle weakness) that occur while the individual remains conscious. Other objectives include examining the impact of Samelisant on attention and alertness, overall quality of life, the spectrum of narcolepsy symptoms, and daily functioning, as well as evaluating its safety profile.
This is a Phase 3, randomized, double-blind, placebo-controlled, parallel-group, multicenter study to evaluate the efficacy and safety of Samelisant compared to placebo in the treatment of excessive daytime sleepiness in male or female participants ≥18 years of age with narcolepsy with and without cataplexy. Participants will be randomized to receive either Samelisant or matching placebo tablets for duration of 12 weeks. Treatment allocation will remain blinded to both participants and investigators throughout the study, except in cases of medical necessity.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
240
Tablet dosage form, once a day
Matching placebo tablets, once a day
Change from Baseline in total Epworth Sleepiness Scale (ESS) score at Week 12
The ESS is a subjective measure of daytime sleepiness. The participant rates on a 4-point Likert scale how likely it is that he/she would doze in 8 different situations. Scoring of the answers is 0 to 3, with 0 being "would never doze" and 3 being "high chance of dozing". The total ESS score ranges from 0 to 24, with higher scores indicating greater daytime sleepiness. A decrease from baseline in ESS score represents improvement.
Time frame: Baseline to Week 12
Change from Baseline for Maintenance of Wakefulness Test (MWT) score at Week 12
MWT is an objective test of sleepiness that evaluates a person's ability to remain awake under soporific conditions for a defined period of time. In the MWT, time from start of the test to the time point of falling asleep will be measured, the total score can range from 0 - 30 minutes. Higher values represent a better outcome.
Time frame: Baseline to Week 12
Change from Baseline in the Clinical Global Impression of Severity of Illness (CGI-S) score as related to excessive daytime sleepiness (EDS) at Week 12
The CGI-S will be used to rate the severity of each participant's illness related to depressive narcolepsy or EDS symptoms on a 7-point scale, which includes the following gradations: 1 = normal, not at all ill; 2 = borderline ill; 3 = mildly ill; 4 = moderately ill; 5 = markedly ill; 6 = severely ill; and 7 = among the most extremely ill.
Time frame: Baseline to Week 12
Change from Baseline in Weekly Cataplexy Rate (WCR) for Narcolepsy Type 1 (NT1) at Week 12
The WCR is a measure designed to evaluate the average weekly cataplexy frequency in participants who experience cataplexy. Participants who experience cataplexy will complete a daily diary to record the number of cataplexy attacks that occur each day beginning after discontinuation of narcolepsy medication and throughout the 12-week treatment phase of the study.
Time frame: Baseline to Week 12
Change from Baseline in Narcolepsy Severity Scale for Clinical Trials (NSS-CT) score for Narcolepsy Type 1 (NT1) at Week 12
NSS-CT is a 15-item self-administered scale that requires participants to evaluate themselves with respect to symptoms and quantitative aspects of cataplexy/sleep attacks; impact on social, family, and work life, hallucinations; and sleep paralysis. Each item requires participants to choose among 4 or 6 options. Scores range from 0 to 57 points with the following breakdown: 0 to 14 (mild), 15 to 28 (moderate), 29 to 42 (severe), 43 to 57 (very severe), where degree of severity describes the impact of the narcolepsy on the participant's life.
Time frame: Baseline to Week 12
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